03 September 2008

Low blood sugar and migraine


So I have once again fiddled with my diet. Now, on top of avoiding gluten, corn sugar, almonds, ginger and all the migraine causing things like: nitrates, msg, caffeine, aspartame, etc., I am also watching my sugar intake. Why, you may ask, would I want to eliminate or drastically curtail yet another food group? My reasons are threefold and all have to do with the high-glycemic value of most non-gluten containing grains.

1: I cannot get control of my weight since going gluten-free.

2: I have noticed a correspondence between low blood sugar episodes and my migraines.

3: I seem to get sugar “crashes” during exercise which makes problems No.1 and 2 worse.

I have known since high school that skipping meals, fasting, or waiting too long between meals is a sure recipe for a headache of any kind. So, for years I have made sure I eat something every 3-4 hours. The trouble is, as I have gotten older, I have noticed that this doesn't ensure I won't have a sugar “crash” which can and has brought on a headache. I even tried making sure I ate protein with my snacks, and it didn't seem to matter. 

Ten years ago, I gave up regular coffee at breakfast (which was a HUGE sacrifice for me) and noticed that the sugar crashes stopped. Great, I thought. Then a few years ago I noticed that if I had jam on my morning toast, I would have a sugar crash a couple hours later. After I gave up gluten, I started indulging in buckwheat frozen waffles for breakfast...with fruit and maple syrup (avoiding the corn syrup, of course). One day in May of 2007 I ate that for breakfast and had one of the worst sugar crashes of my life and as luck would have it, just as the weakness, lightheadedness and shaking started, I saw a bright light from the glare of sunlight reflecting off a window and — bam! Classic migraine (with aura). My day was shot. I took a triptan drug (Amerge) but it took 2 hours to work and I felt lousy the rest of the day.

Two weeks ago I had a ham sandwich on Tapioca Bread with lettuce, tomato and a few baby carrots and I grabbed a couple of potato chips off my husband's plate (!) and an hour and a half later in the middle of teaching our Naginata class, I had the mother of all sugar crashes. I had to stop practicing and since I hadn't thought to bring food with me, my only choice was to get orange juice out of the vending machine and chug it down while I sat on the bleachers waiting for the shaking to stop. Not good.

I had to find a way to eliminate refined carbs from my diet. Not easy when you have an egg allergy that you are not sure is a real allergy or just an intolerance and a moderate cow's milk allergy. I am a lifetime member of Weight Watchers and I had been struggling trying not to eat too many carbs. I looked on the WW forum under restricted diets and noticed that all the gluten intolerant and allergy sufferers were doing the “Core Program” which is based on real food, whole grains, etc. Sounds good, but I had avoided it because of the egg and milk problems I had. Same with South Beach Diet. Most breakfasts that are low carb seem to revolve around eggs.

I decided to try doing the Core program like the first phase of South Beach for 2 weeks and see if I could handle the eggs a little. At first it worked like a dream. I lost the sugar crashes and the sugar cravings and seemed to be ok with a little egg. Then on the third or fourth day I crashed big time. Could barely get out of bed I was so fatigued. I happened to be reading a book by Dr. Diana Schwarzbein about the importance of balancing carbs, protein and fat, especially if your adrenals are burned out...which I suspect mine are. Dr. Schwarzbein says that if you eliminate carbs altogether in that situation, you burn out your adrenals even more and will end up even more fatigued. So, I added some whole grains back in and things are going better now. I am not really missing the refined carbs now and they will taste even better when they are a rare treat instead of an everyday craving. Headaches have been fewer and really only resurfaced after I weakened and ate some chocolate the other day (!). Breakfasts are the most challenging, but I am rediscovering tofu as an egg substitute. Check out my lamb sausage tofu scramble. It's delicious and not too time consuming if you cut up the tofu ahead of time and refrigerate.

Lamb Sausage and Tofu Scramble

2 oz. loose lamb sausage (nitrite-free)
2 oz. firm tofu cut into small cubes
olive oil
1 green onion
1 T fresh mint, minced
1/4 cup or so cucumber, chopped
1/4 cup or so yellow squash, chopped
1 mushroom, chopped
1/4 cup tomato, chopped
salt and pepper to taste

pour a little olive oil in a non-stick skillet on medium heat
add lamb sausage and cook, breaking up with a wooden spoon
add tofu and cook until heated through
add squash, cucumber, mushroom and tomato and cook a minute or two
season with salt and pepper
add green onion and mint and cook another minute

makes one serving (5-6 WW points if you’re counting, depending on how much oil you use)
(note: lamb is pretty greasy, you won't need much oil, just enough for flavor)

Enjoy! You won't be hungry until lunch!

Karen, herself